HIX Analytics—Once and Future Data

As the March 31st open enrollment deadline for individual health plans under the ACA closed, the focus has now turned to the data generated by the state health exchanges. This data will help reveal how the initial enrollment period worked, and ultimately can determine healthcare outcomes and costs—once the data comes in. And that’s going to take a while, state exchange experts agree. Officers from the exchanges for Connecticut and Rhode Island spoke at the State Healthcare IT Connect Summit in Baltimore.

In the last six months, Access Health Connecticut, the state’s health exchange, enrolled more than 200,000 customers. Yesterday alone, a phone bank accustomed to 2,000 to 5,000 calls a day received 15,000 calls, while the exchange website received about 7,000 customers (up from the normal 800), said James Wadleigh, chief information officer. “All this is data that we’re using to modify what we have going on, to improve web site traffic, as well as the phone bank,” he said. “We’re also going to use this data to reach out to younger age groups, middle-aged and older groups.”

In neighboring Rhode Island, 28,000 individuals enrolled in HealthSource RI, that state’s healthcare exchange, said special advisor Brenda Gleason. Another 56,000 enrolled in Medicaid. Rhode Island took a different tack from Connecticut, focusing more on small business employers. The state is one of 10 that decided to enact a small business exchange under the ACA (the federal plan has been postponed until 2015/2016). “Like in many states, in Rhode Island 90 percent of employees work for a small business,” Gleason said. Since this means most people are getting insurance from a small business, HealthSource is looking at data to help understand how employers decide on health plan options and how the new exchanges can provide more options for employees and cut employer costs.

Both states were surprised to see that many enrollees were buying up to a Gold plan, and 20 percent of Medicaid customers “upgraded” to a Qualified Health Plan (QHP). As more people enroll over the years, both exchanges will monitor this trend to see if it continues.

One of the biggest challenges for the health exchanges will be managing expectations, which will include asking a great deal from data gathering. “There’s an expectation that ACA will lower healthcare costs in year one,” said Wadleigh. “But this year, our goal is to get everyone to have healthcare.” After at least two years, claims data and financial sustainability figures will help provide real numbers that can see if ACA is meeting its ultimate goal—a healthier nation.

HIX Analytics: What Data is being Utilized and How Will it be Used?Brenda Gleason, Special Advisor to HealthSource R.I.James Wadleigh, Chief Information Officer, Access Health ConnecticutYvonne Powell, Senior Vice President, The Lewin GroupView HD Video Session and download the accompanying PPTs

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